Retrospective survey of drug-induced liver disease at Groote Schuur Hospital, Cape Town--1983-1987.
In a survey of patients admitted to the medical and surgical wards of Groote Schuur Hospital during the 5-year period 1983-1987 38 patients with severe drug-induced hepatitis were identified. Fifty-three per cent of these reactions were caused by anti-tuberculosis drugs, 21% to phenytoin and 11% to methyldopa. Whereas 82% of the patients were jaundiced, only one-third had gastro-intestinal symptoms and/or fever and only 24% had a rash. Twenty-six per cent of patients were encephalopathic on admission. The overall mortality rate was 24%. Forty per cent of patients with hepatitis caused by anti-tuberculosis therapy died. Many patients had continued to receive therapy despite signs of liver disease. These findings underline the need for a high index of suspicion in the diagnosis of drug-induced liver disease and for early withdrawal of the offending agent(s).
Parrish
A G
AG
MRC Liver Research Centre, University of Cape Town.
Robson
S C
SC
Trey
C
C
Kirsch
R E
RE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology
D000995:Antitubercular Agents